Asunto(s)
Aneurisma Falso , Ventrículos Cardíacos , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/diagnóstico , Ventrículos Cardíacos/diagnóstico por imagen , Masculino , Ecocardiografía/métodos , Aneurisma Cardíaco/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodosRESUMEN
Pseudoaneurysm is the formation of a sac due to damage in the continuity of the arterial wall. Iatrogenic carotid artery aneurysm is a rare, life-threatening complication following fine needle aspiration (FNA). We are presenting here a case of pseudoaneurysm following FNA with a literature review.
Asunto(s)
Aneurisma Falso , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Biopsia con Aguja Fina/efectos adversos , Traumatismos de las Arterias Carótidas/etiología , Traumatismos de las Arterias Carótidas/diagnóstico , Traumatismos de las Arterias Carótidas/diagnóstico por imagen , Enfermedad Iatrogénica , Cuello/patologíaRESUMEN
We present a compelling case of an elderly male with a complex medical history who presented with sepsis secondary to a urinary tract infection. During admission, changes in his abdominal exam prompted imaging studies, which revealed a grade IV splenic laceration with a giant splenic artery pseudoaneurysm containing a suspected arteriovenous fistula component. Multidisciplinary discussion was had regarding patient management which resulted in the decision to perform an emergent splenectomy. Learning points from this case underscore the crucial role of interdisciplinary collaboration in the treatment of this pathology. Additionally, we discuss the decision-making process to support surgical intervention in the absence of clear guidelines in this exceedingly rare condition.
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Aneurisma Falso , Fístula Arteriovenosa , Esplenectomía , Arteria Esplénica , Humanos , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Masculino , Arteria Esplénica/diagnóstico por imagen , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/complicaciones , Fístula Arteriovenosa/cirugía , Fístula Arteriovenosa/terapia , Fístula Arteriovenosa/etiología , Bazo/irrigación sanguínea , Bazo/diagnóstico por imagen , Bazo/lesiones , Anciano , Tomografía Computarizada por Rayos XAsunto(s)
Aneurisma Falso , Ventrículos Cardíacos , Imagen por Resonancia Magnética , Humanos , Imagen por Resonancia Magnética/métodos , Aneurisma Falso/diagnóstico , Ventrículos Cardíacos/diagnóstico por imagen , Masculino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/diagnóstico por imagenRESUMEN
BACKGROUND When people in their 60s experiences abdominal pain, vomiting, and unexplained weight loss without a history of abdominal surgery, the usual diagnosis is obstruction caused by a neoplastic mass. Nevertheless, in exceptionally rare cases, these symptoms arise from complications linked to a visceral artery aneurysm. CASE REPORT We present a case of a 60-year-old man with immunodeficiency and Sneddon-Wilkinson disease (a rare subcorneal pustular dermatosis), who developed a pancreaticoduodenal aneurysm of uncertain origin, associated with pancreatic mass, retroperitoneal hematoma, and duodenal obstruction. The treatment approach included transcatheter arterial coil embolization with supportive measures such as parenteral nutrition, a nasogastric tube, octreotide administration, and antiemetics. Despite these interventions, persistence gastrointestinal symptoms prompted an endoscopic ultrasound fine-needle aspiration to rule out malignancy. The biopsy confirmed localized fibro-inflammation. Although he was initially considered for a gastro-jejunal bypass, conservative management effectively improved the pancreatic lesion and duodenal obstruction, leading to discontinuation of parenteral nutrition. The patient was able to resume a regular diet 4 weeks after embolization. CONCLUSIONS Pancreaticoduodenal artery aneurysm is a rare visceral aneurysm with multiple etiologies and potentially fatal consequences. We report an unusual case of a pancreaticoduodenal artery aneurysm associated with pancreatic mass and duodenal obstruction. This diagnosis warrants consideration when an immunodeficient patient presents symptoms of abdominal pain and vomiting. Early endovascular embolization, combined with conservative approaches, effectively alleviated the symptoms in our patient.
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Aneurisma Falso , Obstrucción Duodenal , Duodeno , Páncreas , Humanos , Masculino , Persona de Mediana Edad , Aneurisma Falso/terapia , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Páncreas/irrigación sanguínea , Obstrucción Duodenal/etiología , Duodeno/irrigación sanguínea , Embolización TerapéuticaAsunto(s)
Aneurisma Falso , Aneurisma Cardíaco , Tabique Interventricular , Humanos , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/diagnóstico , Tabique Interventricular/diagnóstico por imagen , Tabique Interventricular/cirugía , Aneurisma Cardíaco/etiología , Aneurisma Cardíaco/cirugía , Aneurisma Cardíaco/diagnóstico por imagen , Aneurisma Cardíaco/diagnóstico , Prótesis Valvulares Cardíacas , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Estenosis de la Válvula Aórtica/cirugía , Estenosis de la Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Válvula Aórtica/diagnóstico por imagen , Masculino , Anciano , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico , Resultado del Tratamiento , FemeninoRESUMEN
We aimed to analyze the feasibility of endovascular treatment for brucellosis-related aorta-iliac artery pseudoaneurysm. We did a statistical analysis that among the 11 cases, the thoracic aorta was involved in 3 cases, the abdominal aorta was involved in 6 cases, and the iliac artery was involved in 2 cases. Five patients had a history of contact with cattle and sheep, 3 had a history of drinking raw milk, 10 patients had a fever before the operation, and 11 patients had positive serum agglutination test. Blood culture was positive in 2 patients. All patients were given anti-brucellosis treatment immediately after diagnosis. One died of aortic rupture 5 days after emergency endovascular gastrointestinal bleeding. Endovascular-covered stent implantation and active anti-brucellosis therapy were used to treat 10 patients. The follow-up period was 8 years without aortic complications or death for all patients. We think early diagnosis and a combination of anti-brucellosis drugs and endovascular therapy may be the first choice for treating the pseudoaneurysm caused by Brucella.
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Aneurisma Falso , Brucelosis , Procedimientos Endovasculares , Humanos , Aneurisma Falso/terapia , Aneurisma Falso/microbiología , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Brucelosis/complicaciones , Brucelosis/diagnóstico , Masculino , Procedimientos Endovasculares/métodos , Femenino , Persona de Mediana Edad , Adulto , Stents , Anciano , Aneurisma Infectado/microbiología , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/terapia , Arteria Ilíaca/cirugía , Aneurisma Ilíaco/microbiología , Aneurisma Ilíaco/cirugía , Aneurisma Ilíaco/terapia , Aneurisma Ilíaco/diagnóstico por imagen , Antibacterianos/uso terapéutico , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
PURPOSE: Maxillary sinus carcinomas usually present as a locally advanced disease at the time of diagnosis and it is extremely unusual to have a second primary maxillary carcinoma on the contralateral side after many years of completion of treatment of the first malignancy. We present here a case report of a sphenopalatine artery (SPA) pseudoaneurysm mimicking the second primary maxillary carcinoma. METHODS: We reviewed the literature for SPA pseudoaneurysm. RESULTS/CASE REPORT: This report describes the case of a 90-year-old man with a background of adenoid cystic carcinoma of the right maxillary sinus, diagnosed and treated with surgery and radiotherapy 14 years ago, who presented with a history of multiple episodes of epistaxis. The radiological evaluation showed a heterogeneously enhancing mass with a central hemorrhagic component and surrounding bony erosions in the left maxillary sinus and the patient was planned for biopsy from the suspicious mass along with SPA ligation. However, on opening the maxillary antrum there was excessive bleeding and it was determined unsafe to proceed further. The patient was subsequently taken to interventional radiology for diagnostic angiography which revealed an SPA pseudoaneurysm that was subsequently embolized successfully. CONCLUSIONS: Sphenopalatine artery pseudoaneurysms should be considered as a differential for recurrent epistaxis in patients with a history of sinonasal malignancy. In such cases, endovascular embolization is a viable management option.
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Aneurisma Falso , Humanos , Masculino , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/diagnóstico , Aneurisma Falso/terapia , Anciano de 80 o más Años , Diagnóstico Diferencial , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico por imagen , Neoplasias Primarias Secundarias/patología , Neoplasias del Seno Maxilar/diagnóstico , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/patología , Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/diagnóstico por imagen , Epistaxis/etiología , Arteria Maxilar/diagnóstico por imagenRESUMEN
Pseudoaneurysm of the internal carotid artery caused by skull base osteomyelitis (SBO) is a lethal condition seen in immunocompromised patients, predominantly those with diabetes mellitus. Cranial nerve involvement is a common complication and generally indicates a poor prognosis. We report the case of a 62-year-old diabetic patient who presented with isolated sixth cranial nerve palsy. She had uncontrolled blood sugar levels and high erythrocyte sedimentation rate, and she suffered from pyelonephritis. Neuroimaging detected SBO with multiple secondary mycotic pseudoaneurysms prominent at the petrocavernous junction. Ischemia is the most common etiology for an isolated abducens nerve palsy, but in certain cases neuroimaging is warranted to prevent life-threatening complications. This case highlights the importance and urgency of identifying and managing such conditions.
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Enfermedades del Nervio Abducens , Aneurisma Falso , Micosis , Osteomielitis , Femenino , Humanos , Persona de Mediana Edad , Aneurisma Falso/complicaciones , Aneurisma Falso/diagnóstico , Enfermedades del Nervio Abducens/etiología , Enfermedades del Nervio Abducens/complicaciones , Base del Cráneo , Osteomielitis/complicaciones , Neuroimagen/efectos adversos , Micosis/complicacionesRESUMEN
A 78-year-old male patient with a history of coronary artery disease (he had undergone coronary artery bypass surgery 4 years ago), heart failure with mildly reduced ejection fraction, diabetes mellitus, and transient ischemic attack presented to the emergency department with complaints of dyspnea (New York Heart Association Class 4) despite the optimal medical therapy.
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Aneurisma Falso , Cateterismo Cardíaco , Ventrículos Cardíacos , Humanos , Masculino , Anciano , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Aneurisma Falso/terapia , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Cateterismo Cardíaco/métodos , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/cirugía , Resultado del Tratamiento , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/cirugía , Enfermedad de la Arteria Coronaria/terapiaRESUMEN
INTRODUCTION: Traumatic intracranial aneurysms are rare, making up about 1% of all intracranial aneurysms. They can happen due to direct injury or blunt force, with the middle cerebral artery being the most frequent site. The middle meningeal artery (MMA) is the main artery that supplies the cranial dura mater, and, because of its location, is susceptible to damage after trauma. This article reported an unusual case of giant post-traumatic MMA pseudoaneurysm. CASE: A 45 year-old man was referred to our department with a history of craniectomy. He complained of non-specific headache, but neurological examination was normal. A follow-up brain CT scan identified a right temporal fossa hyperdense mass. Digital subtraction angiography diagnosed a traumatic MMA aneurysm. The patient was treated with preoperative aneurysm embolization and surgical resection. DISCUSSION: Traumatic MMA aneurysm is a rare presentation after head trauma. It can manifest as epidural hematoma, subdural hematoma or intraparenchymal hematoma, and sometimes resembles the present case, which was discovered incidentally. CONCLUSION: Pseudoaneurysm is a rare complication of MMA trauma, with late presentation. It should be considered in patients with history of traumatic brain injury and temporal fossa extra-axial mass lesion with vascular characteristics.
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Aneurisma Falso , Traumatismos Craneocerebrales , Hematoma Epidural Craneal , Aneurisma Intracraneal , Masculino , Humanos , Persona de Mediana Edad , Aneurisma Falso/diagnóstico , Aneurisma Falso/etiología , Aneurisma Falso/cirugía , Aneurisma Intracraneal/diagnóstico , Aneurisma Intracraneal/etiología , Aneurisma Intracraneal/cirugía , Arterias Meníngeas/diagnóstico por imagen , Arterias Meníngeas/lesiones , Hematoma Epidural Craneal/etiología , Traumatismos Craneocerebrales/complicacionesRESUMEN
A 12-year-old female with pulmonary artery stenosis developed pseudoaneurysms due to septic embolism, requiring close follow-up.
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Aneurisma Falso , Embolia Pulmonar , Tetralogía de Fallot , Femenino , Humanos , Niño , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Tetralogía de Fallot/complicaciones , Tetralogía de Fallot/cirugía , Aneurisma Falso/diagnóstico , Aneurisma Falso/diagnóstico por imagen , Embolia Pulmonar/etiología , Embolia Pulmonar/complicacionesAsunto(s)
Aneurisma Falso , Corazón Auxiliar , Humanos , Corazón Auxiliar/efectos adversos , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Masculino , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/etiología , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/cirugía , Aneurisma Infectado/etiología , Persona de Mediana Edad , Insuficiencia Cardíaca/cirugíaRESUMEN
A small number of case reports have documented a link between atlantoaxial dislocation (AAD) and vertebral artery dissection (VAD), but this association has never been described in patients with hereditary connective tissue disorders. We present a case of an 18-year-old female patient, diagnosed with Marfan syndrome since the age of one, who underwent brain MRA for intracranial aneurysm screening revealing tortuosity of the internal carotid and vertebral arteries as well as atlantoaxial dislocation. Since the patient was asymptomatic, a wait-and-see approach was chosen, but a follow-up MRA after 18 months showed the appearance of a dissecting pseudoaneurysm of the V3 segment of the left vertebral artery. Despite the patient being still asymptomatic, it was decided to proceed with C1-C2 stabilization to prevent further vascular complications. Follow-up imaging showed realignment of the atlantoaxial joint and reduction of the dissecting pseudoaneurysm of the left vertebral artery. In our patient, screening MRA has led to the discovery of asymptomatic arterial and skeletal abnormalities which, if left untreated, might have led to severe cerebrovascular complications. Therefore, AAD correction or close monitoring with MRA should be provided to MFS patients with this craniovertebral junction anomaly, even if asymptomatic.
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Aneurisma Falso , Aneurisma Intracraneal , Luxaciones Articulares , Síndrome de Marfan , Disección de la Arteria Vertebral , Femenino , Humanos , Adolescente , Disección de la Arteria Vertebral/diagnóstico , Disección de la Arteria Vertebral/diagnóstico por imagen , Síndrome de Marfan/complicaciones , Síndrome de Marfan/diagnóstico , Aneurisma Falso/diagnóstico , Aneurisma Falso/diagnóstico por imagen , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/anomalías , Luxaciones Articulares/complicaciones , Luxaciones Articulares/diagnósticoAsunto(s)
Aneurisma Falso , Aneurisma Coronario , Angiografía Coronaria , Trasplante de Corazón , Humanos , Trasplante de Corazón/efectos adversos , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Aneurisma Falso/diagnóstico por imagen , Masculino , Aneurisma Coronario/etiología , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/cirugía , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Vasos Coronarios/diagnóstico por imagen , Persona de Mediana EdadRESUMEN
INTRODUCTION: aneurysms are focal and permanent dilations of an artery; in pseudoaneurysms, the normal layers of the blood vessel are replaced by fibrous tissue. Due to their low incidence, as well as the diagnostic and therapeutic challenge they represent; our objective is to present the clinical case of a pseudoaneurysm of a digital artery of the hand and to carry out a systematic review of this pathology. MATERIAL AND METHODS: literature search in Medline, using the terms "digital artery" and "aneurysm." Studies of vascular dilation pathology affecting the hand and fingers were incorporated. Studies with pathology of proximal involvement of the hand were excluded. CASE PRESENTATION: a 79-year-old female patient who, after a sharp force trauma to the fifth finger of the left hand, develops a rapidly growing necrotic tumor. She had ultrasound and angiography that suggested hematoma. Surgical management was decided, during which it was observed that the tumor involved ulnar collateral digital artery of the fifth finger. The lesion and the arterial segment involved were resected. Post-surgical course without complications. The histopathological diagnosis of pseudoaneurysm of the lesion was confirmed. DISCUSSION: traumatic etiology is the most frequent cause of digital aneurysms. Risk factors for pseudoaneurysms include sharp force trauma and alterations of the coagulation pathways, as in the case presented. CONCLUSION: the pseudoaneurysm of a digital artery is a rare pathology with great variability of therapeutic management. Surgical resection of the lesion with vascular flow reconstruction is the recommended treatment.
INTRODUCCIÓN: los aneurismas son dilataciones vasculares localizadas y permanentes de una arteria; en los pseudoaneurismas, las capas normales del vaso sanguíneo son reemplazadas por tejido fibroso. Debido a su baja incidencia, así como el desafío diagnóstico y terapéutico que representan; nuestro objetivo es presentar el caso clínico de un pseudoaneurisma de una arteria digital de la mano y realizar una revisión sistemática sobre dicha patología. MATERIAL Y MÉTODOS: búsqueda bibliográfica en Medline, utilizando los términos "arteria digital" y "aneurisma". Se incorporaron estudios de patología de dilatación vascular que afecte la mano y los dedos. Se excluyeron trabajos con patología de afección proximal de la mano. PRESENTACIÓN DE CASO: paciente femenino de 79 años de edad, que posterior a herida cortante de quinto dedo de mano izquierda, desarrolla tumoración necrótica de rápido crecimiento. Contaba con ecografía y angiografía que sugerían hematoma. Se decidió manejo quirúrgico, durante el cual se observó que la tumoración involucraba arteria digital colateral cubital del quinto dedo. Se resecó lesión y segmento arterial involucrado. Cursó postquirúrgico sin complicaciones. Se confirmó el diagnóstico histopatológico de pseudoaneurisma de la lesión. DISCUSIÓN: la etiología traumática es la causa más frecuente de los aneurismas digitales. Los factores de riesgo para los pseudoaneurismas incluyen lesiones penetrantes y alteraciones de la cascada de coagulación, como en el caso presentado. CONCLUSIÓN: el pseudoaneurisma de una arteria digital es una patología rara y con gran variabilidad de manejo terapéutico. La resección quirúrgica de la lesión con la reconstrucción del flujo vascular, es el tratamiento recomendado.
Asunto(s)
Aneurisma Falso , Aneurisma , Neoplasias , Femenino , Humanos , Anciano , Aneurisma Falso/diagnóstico , Aneurisma Falso/cirugía , Aneurisma Falso/etiología , Arterias , Aneurisma/complicaciones , Ultrasonografía/efectos adversos , Neoplasias/complicacionesRESUMEN
OBJECTIVE: To describe two different degrees of clinical commitment and results in the evolution of infectious endarteritis in patients without a previous diagnosis of aortic coarctation. CASE DESCRIPTION: Two male patients aged 13 and 9 years old were admitted. The first due to a fever for 2 months, which started after dental cleaning, and the second due to high blood pressure, both patients with asthenia and weight loss. In the first case, the transthoracic echocardiogram showed aortic coarctation, and the transesophageal echocardiogram showed the presence of vegetations in the post-coarctation area, without pseudoaneurysms, with blood culture positive for Streptococcus mitis. This patient was treated for six weeks with crystalline penicillin, resolving the infection without complications. The second case was assessed for high blood pressure with a history of fever, and was treated with antibiotics. When performing a transthoracic echocardiogram, aortic coarctation was observed with a saccular image classified as a pseudoaneurysm by angiography and tomography. Blood culture was negative, and the patient developed an episode of hematemesis whose initial etiology could not be determined. Before surgical repair, he had a second episode of copious hematemesis with hypovolemic shock and death. COMMENTS: We need to have a high index of clinical suspicion to establish the diagnosis of aortic coarctation complicated by endarteritis and start the appropriate antibiotic treatment, always maintaining surveillance for the early detection of pseudoaneurysms.